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General NPI Number Information
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NPI Number | 1871821603
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Entity Type | Individual
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Provider Name | ANASTASIA KATRINA SMITH ACSW, CMSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 03/15/2010
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Provider Practice Location Address
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Address Line | 727 N MAIN ST
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City | EMPORIA
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State | VA
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Zip | 23847-1274
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Country | US
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Telephone | 434-348-4603
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Fax | 434-348-4938
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Provider Business Mailing Address
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Address Line | 411 SOUTH ST E
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City | AHOSKIE
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State | NC
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Zip | 27910-3539
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Country | US
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Telephone | 252-398-6077
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007023
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C004393
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License Number State | NC
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